Biomechanical constraints remain major risk factors for low back pain
Prospective study among French workers
RESULTS
RAMOND-ROQUIN A
1,2, PETIT LE MANACH A
1, BODIN J
1, SERAZIN C
1, PAROT E
1,3, HA C
4, ROQUELAURE Y
1,51Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers ; 2Department of General Practice, University of Angers ;
3 Center of Clinical Research, University Hospital of Angers ; 4Institute of Health Surveillance, Saint-Maurice ; 5 Department of Occupational Health,
University of Angers aline.ramond@univ-angers.fr
METHODS
DISCUSSION & CONCLUSION
One in two adults suffer from LBP at least once a year1
Direct costs for chronic LBP :
~ 715 € per patient every 6 months2
Impact on occupational settings : LBP = the most frequent reason for sick leave3
Low back pain (LBP) in France : A major public health problem
OBJECTIVE Prospective modelling of the risk of LBP in the French male working population INTRODUCTION
2002 Random selection of workers by their occupational physician.
Men – 20 to 59 years old – Loire Valley region of West-Central France.
First self-administered questionnaire
Second self-administered questionnaire (sent to men included in the first survey)
Statistical analysis:
Multivariate and multi-step logistic modelling of the risk of LBP in the male workers.
Selection of statistically significant risk factors (p<0.05) and confounding factors.
21 risk factors : biomechanical organizational psychosocial individual
Binary outcome :
LBP during the last 7 days ? Design :
Cohort prospective study2161
male workers (first self-administered questionnaire) Age, occupations and economic sectors ≈ regional distribution1313
men (second self-administered questionnaire) Prevalence LBP during the last 7 days : 30%Unreachable people (n=146 : death/unknown address) Unanswered people (n=702)
Study population :
Final multivariate model
(n=1255 due to missing data):RISK FACTORS OR (IC 95)†
Frequent bending (more than 2 hours daily)
No Forward Sideways Both
1 1.45 (1.07-1.97) 1.78 (0.74-4.27) 2.13 (1.52-3.00) Driving industrial vehicles Never
Occasionally/Often
1 1.35 (1.00-1.81) Working more hours than
officially planned
No Yes
1 1.38 (1.05-1.81) Low support from
supervisors
No Yes
1 1.35 (1.02-1.79) Low skill discretion No
Yes
1 1.28 (0.95-1.72)
F ir st s u rv e y S e co n d s u rv e y
† Odds-ratios for LBP and confidence intervals at 95%
2002/2005
2007/2009
Prospective study ; diversified cohort of male workers ; numerous risk factors Useful and relevant to the development ofpublic health policyfor workers.
Current research on LBP focus on psychosocial factors.
However biomechanical constraints (frequent bending, driving industrial vehicles) remain major risk factors that deserve to be considered in primary prevention ! 2005
2007
2009
Ethical aspects :
Written consent from the workers - Authorization from the National Commission of Data Protection
REFERENCES
1Gourmelen J, Chastang JF, Ozguler A et al. Frequency of low back pain among men and women aged 30 to 64 years in France. Results of two national surveys. Ann Readapt Med Phys. 2007 Nov;50(8):640-4, 633-9
2Depont F, Hunsche E, Abouelfath A et al. Medical and non- medical direct costs of chronic low back pain in patients consulting primary care physicians in France. Fundam Clin Pharmacol. 2010 Feb;24(1):101-8.
3Caisse Nationale d’Assurance Maladie - Travailleurs Salariés.